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Persistence of abnormal gastrointestinal motility after operation for Hirschsprung's disease.
Am J Gastroenterol. 2000 May; 95(5):1226-30.AJ

Abstract

OBJECTIVE

Recent studies in patients with Hirschsprung's disease (HD) suggest that morphological abnormalities of the intramural intestinal plexuses are not restricted to the colon. In this report, symptoms and objective tests of gastrointestinal (GI) motor dysfunction were determined long after operative treatment to see whether evidence of a more widespread and relevant motility disturbance could be detected.

METHODS

Twenty-one children were available for study an average of 6.6 yr after surgery for HD. All of these patients underwent evaluation of bowel frequency per week, total GI transit time (TGTT), and a scintigraphic gastric emptying test using solid food; anorectal manometry and segmental colonic transit times were performed in a subset of patients. Results were compared with findings in appropriately matched controls.

RESULTS

Frequency of defecation per week in patients with HD after surgery was not different from that in control children, but TGTT was significantly longer (p < 0.01). Percentage retention of gastric isotope at 60 min exceeded the normal range in 12 of 21 (57.1%) patients, and colonic transit was abnormal in all six children studied. Symptoms persisted in two-thirds of patients postoperatively, and transit abnormalities were more common in the symptomatic subset (p = 0.026).

CONCLUSIONS

Our data show that, in a subset of patients with HD, GI motor dysfunction persists long after surgical correction. The heterogeny of basic defects responsible for HD could provide the substrate for these motor abnormalities that, in turn, seem at least partially responsible for continuation of the symptomatic state.

Authors+Show Affiliations

Department of Pediatrics, University Federico II, Naples, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10811332

Citation

Miele, E, et al. "Persistence of Abnormal Gastrointestinal Motility After Operation for Hirschsprung's Disease." The American Journal of Gastroenterology, vol. 95, no. 5, 2000, pp. 1226-30.
Miele E, Tozzi A, Staiano A, et al. Persistence of abnormal gastrointestinal motility after operation for Hirschsprung's disease. Am J Gastroenterol. 2000;95(5):1226-30.
Miele, E., Tozzi, A., Staiano, A., Toraldo, C., Esposito, C., & Clouse, R. E. (2000). Persistence of abnormal gastrointestinal motility after operation for Hirschsprung's disease. The American Journal of Gastroenterology, 95(5), 1226-30.
Miele E, et al. Persistence of Abnormal Gastrointestinal Motility After Operation for Hirschsprung's Disease. Am J Gastroenterol. 2000;95(5):1226-30. PubMed PMID: 10811332.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Persistence of abnormal gastrointestinal motility after operation for Hirschsprung's disease. AU - Miele,E, AU - Tozzi,A, AU - Staiano,A, AU - Toraldo,C, AU - Esposito,C, AU - Clouse,R E, PY - 2000/5/16/pubmed PY - 2000/6/3/medline PY - 2000/5/16/entrez SP - 1226 EP - 30 JF - The American journal of gastroenterology JO - Am J Gastroenterol VL - 95 IS - 5 N2 - OBJECTIVE: Recent studies in patients with Hirschsprung's disease (HD) suggest that morphological abnormalities of the intramural intestinal plexuses are not restricted to the colon. In this report, symptoms and objective tests of gastrointestinal (GI) motor dysfunction were determined long after operative treatment to see whether evidence of a more widespread and relevant motility disturbance could be detected. METHODS: Twenty-one children were available for study an average of 6.6 yr after surgery for HD. All of these patients underwent evaluation of bowel frequency per week, total GI transit time (TGTT), and a scintigraphic gastric emptying test using solid food; anorectal manometry and segmental colonic transit times were performed in a subset of patients. Results were compared with findings in appropriately matched controls. RESULTS: Frequency of defecation per week in patients with HD after surgery was not different from that in control children, but TGTT was significantly longer (p < 0.01). Percentage retention of gastric isotope at 60 min exceeded the normal range in 12 of 21 (57.1%) patients, and colonic transit was abnormal in all six children studied. Symptoms persisted in two-thirds of patients postoperatively, and transit abnormalities were more common in the symptomatic subset (p = 0.026). CONCLUSIONS: Our data show that, in a subset of patients with HD, GI motor dysfunction persists long after surgical correction. The heterogeny of basic defects responsible for HD could provide the substrate for these motor abnormalities that, in turn, seem at least partially responsible for continuation of the symptomatic state. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/10811332/Persistence_of_abnormal_gastrointestinal_motility_after_operation_for_Hirschsprung's_disease_ L2 - https://Insights.ovid.com/pubmed?pmid=10811332 DB - PRIME DP - Unbound Medicine ER -